Healthcare Provider Details

I. General information

NPI: 1386372084
Provider Name (Legal Business Name): SHERI LEE DELAMBO MA, LADC, LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/10/2022
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1068 LAKE ST S STE 109
FOREST LAKE MN
55025-2633
US

IV. Provider business mailing address

1012 4TH ST SE
FOREST LAKE MN
55025-2088
US

V. Phone/Fax

Practice location:
  • Phone: 651-982-4792
  • Fax: 651-982-6035
Mailing address:
  • Phone: 651-815-5018
  • Fax: 651-982-6035

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number5416
License Number StateMN
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number306225
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: